{
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"FirstLineMailingAddress": "2100 DEFOORS FERRY RD NW # 2052",
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"MailingAddressStateName": "GA",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-247-4177",
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"FirstLinePracticeLocationAddress": "1700 NORTHSIDE DR NW STE A7",
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"PracticeLocationAddressCityName": "ATLANTA",
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"EnumerationDate": "07/03/2023",
"LastUpdateDate": "07/03/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SADBERRY",
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"AuthorizedOfficialTelephoneNumber": "281-247-4177",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}